Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Population dynamics of intermediate snail hosts of Fasciola hepatica and some environmental factors in San Juan y Martinez municipality, Cuba

The variation of abundances of intermediate snail hosts of Fasciola hepatica in Cuba (Fossaria cubensis and Pseudosuccinea columella) was studied during one year under natural conditions at five sampling sites in San Juan y Martinez municipality, Pinar del Rio province, Cuba. The effect of some environmental variables on the lymnaeid abundances was also studied. A canonical correspondence analysis showed that both species do not generally occur together in the same habitat and that most factors affect them in an opposite fashion, although both of them correlate positively through time to the diversity of the habitats. F. cubensis prefers the sites that are in or closer to the city whereas P. columella is more abundant in rural sites. Lymnaeid abundances are mainly affected by nitrite and nitrate concentrations as well as by the abundance of the thiarid Tarebia granifera. F. cubensis is more abundant in polluted habitats with low densities (or absence) of T. granifera whereas P. columella prefers cleaner habitats and can coexist with the thiarid, even at its higher densities. The implications of divergent preferences of the two lymnaeids for the control of fasciolosis are discussed.

First isolation of Cryptococcus gattii molecular type VGII and Cryptococcus neoformans molecular type VNI from environmental sources in the city of Belém, Pará, Brazil

Cryptococcus neoformans and Cryptococcus gattii are important agents of meningoencephalitis in humans in the city of Belém. This clinical data suggests that the region may be a highly endemic area for the pathogenic Cryptococcus species within the state of Pará (PA), Northern Brazil. Preliminary analysis of 11 environmental samples from the city of Belém showed two positive locations, including a hollow of a kassod tree (Senna siamea) colonized simultaneously by C. gattii molecular type VGII and C. neoformans molecular type VNI, and a birdcage in a commercial aviary positive for C. neoformans, molecular type VNI. This is the first evidence of an environmental occurrence of molecular types VNI and VGII in PA.

Exploring the association between Trypanosoma cruzi infection in rural communities and environmental changes in the southern Gran Chaco

The association between land use and land cover changes between 1979-2004 in a 2.26-million-hectare area south of the Gran Chaco region and Trypanosoma cruzi infection in rural communities was analysed. The extent of cultural land, open and closed forests and shrubland up to 3,000 m around rural communities in the north, northwest and west of the province of Córdoba was estimated using Landsat satellite imagery. The T. cruzi prevalence was estimated with a cross-sectional serological survey conducted in the rural communities. The land cover showed the same patterns in the 1979, 1999 and 2004 satellite imagery in both the northwest and west regions, with shrinking regions of cultured land and expanding closed forests away from the community. The closed forests and agricultural land coverage in the north region showed the same trend as in the northwest and west regions in 1979 but not in 1999 or 2004. In the latter two years, the coverage remote from the communities was either constant or changed in opposite ways from that of the northwest and west regions. The changes in closed forests and cultured vegetation alone did not have a significant, direct relationship with the occurrence of rural communities with at least one person infected by T. cruzi. This study suggests that the overall decrease in the prevalence of T. cruzi is a consequence of a combined effect of vector control activities and changes in land use and land cover.

Differences in the patent management in Brazilian companies with and without plants abroad

This paper compares the procedures of local Brazilian companies (those which have plants in Brazil only) with those of international Brazilian companies (which have plants in at least two countries) regarding the patent management. Although there are a lot more variables to consider when examining the issue of patents in companies, this study presents and analyzes the results of a qualitative research on the decision to patent innovations, the choice of countries where to patent and the strategic significance of patents to the company.

Disinfection with sodium hypochlorite in hospital environmental surfaces in the reduction of contamination and infection prevention: a systematic review

OBJECTIVETo search for evidence of the efficiency of sodium hypochlorite on environmental surfaces in reducing contamination and prevention of healthcare-associated infection HAIs.METHODSystematic review in accordance with the Cochrane Collaboration.RESULTSWe analyzed 14 studies, all controlled trials, published between 1989-2013. Most studies resulted in inhibition of microorganism growth. Some decreased infection, microorganism resistance and colonization, loss of efficiency in the presence of dirty and surface-dried viruses.CONCLUSIONThe hypochlorite is an effective disinfectant, however, the issue of the direct relation with the reduction of HAIs remains. The absence of control for confounding variables in the analyzed studies made the meta-analysis performance inadequate. The evaluation of internal validity using CONSORT and TREND was not possible because its contents were not appropriate to laboratory and microbiological studies. As a result, there is an urgent need for developing specific protocol for evaluating such studies.

Carbon balance and crop residue management in dynamic equilibrium under a no-till system in Campos Gerais

The adoption of no-tillage systems (NT) and the maintenance of crop residues on the soil surface result in the long-term increase of carbon (C) in the system, promoting C sequestration and reducing C-CO2 emissions to the atmosphere. The purpose of this study was to evaluate the C sequestration rate and the minimum amount of crop residues required to maintain the dynamic C equilibrium (dC/dt = 0) of two soils (Typic Hapludox) with different textural classes. The experiment was arranged in a 2 x 2 x 2 randomized block factorial design. The following factors were analyzed: (a) two soil types: Typic Hapludox (Oxisol) with medium texture (LVTM) and Oxisol with clay texture (LVTA), (b) two sampling layers (0-5 and 5-20 cm), and (c) two sampling periods (P1 - October 2007; P2 - September 2008). Samples were collected from fields under a long-term (20 years) NT system with the following crop rotations: wheat/soybean/black oat + vetch/maize (LVTM) and wheat/maize/black oat + vetch/soybean (LVTA). The annual C sequestration rates were 0.83 and 0.76 Mg ha-1 for LVTM and LVTA, respectively. The estimates of the minimum amount of crop residues required to maintain a dynamic equilibrium (dC/dt = 0) were 7.13 and 6.53 Mg ha-1 year-1 for LVTM and LVTA, respectively. The C conversion rate in both studied soils was lower than that reported in other studies in the region, resulting in a greater amount of crop residues left on the soil surface.

Learning on human resources management in the radiology residency program

Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

Environmental comfort in constructions for Sindi and Guzera calves in the agreste region of the State of Paraiba, Brazil

The objective of this study was to evaluate the quality of air, bioclimatic indexes of facilities and physiological indices of Guzera and Sindhi calves, reared in climatic conditions of Agreste. The study was conducted at the experimental station of Alagoinha, PB, Brazil, using 16 calves of Sindi and Guzerá races. The average concentration of oxygen (20.85%), ammonia (1.99 ppm), carbon monoxide (<0.01 ppm), methane (0.13 ppm) and hydrogen sulfide (<0.01) within facilities, were within the limits established by the Brazilian and international standards, for both animals and workers. The bioclimatic index of temperature and humidity and the temperature of the black globe and humidity index were within the thermal comfort zone for cattle in most of the experimental period, the mean values of respiratory frequency (26.0 min mov-1) and skin temperature (32.3 °C) were higher in the hottest time of the day (1 pm) and rectal temperature (39.3 ºC) in the late afternoon (5 pm), but remained within normal ranges for the studied races. The races have good adaptability to climatic conditions in the region of the Paraibano Agreste, Brazil.

Irrigation management in pruned coffee tree crop

It was evaluated the effect of irrigation management on the production characteristics of coffee cultivar Acaiá MG-1474, planted in spacing of 3.00 m x 0.60 m, pruned in 2004, and irrigated by drip since the planting, in 1997. The experimental designed used was of randomized blocks with five treatments and four replications. The treatments consisted of irrigation management strategies, applying or not applying controlled moisture deficit in layer of 0 to 0.4m, in dry seasons of the year: A = no irrigation (control), B = irrigation during all year considering the factor of water availability in the soil (f) equal to 0.75, C = irrigation during all year considering f = 0.25, D = irrigation during all year, but in January /February /March /July /October /November /December with f = 0.25 and April /May /June /August /September with f = 0.75, E = irrigation only during April /May /June /August /September with f = 0.25. From July /2005 to June /2007 the applied water depth was defined based on Class A pan evaporation (ECA) and the period from July/2007 to June/2008 based on readings of matric potential of soil obtained from Watermark® sensors. Each plot consisted of three rows with ten plants per row, considering as useful plot five plants of center line. The results indicated that the E irrigation management was the most suitable for technical reasons.

Application of artificial neural networks as an alternative to volumetric water balance in drip irrigation management in watermelon crop

Precision irrigation seeks to establish strategies which achieve an efficient ratio between the volume of water used (reduction in input) and the productivity obtained (increase in production). There are several studies in the literature on strategies for achieving this efficiency, such as those dealing with the method of volumetric water balance (VWB). However, it is also of great practical and economic interest to set up versatile implementations of irrigation strategies that: (i) maintain the performance obtained with other implementations, (ii) rely on few computational resources, (iii) adapt well to field conditions, and (iv) allow easy modification of the irrigation strategy. In this study, such characteristics are achieved when using an Artificial Neural Network (ANN) to determine the period of irrigation for a watermelon crop in the Irrigation Perimeter of the Lower Acaraú, in the state of Ceará, Brazil. The Volumetric Water Balance was taken as the standard for comparing the management carried out with the proposed implementation of ANN. The statistical analysis demonstrates the effectiveness of the proposed management, which is able to replace VWB as a strategy in automation.

QT interval in healthy dogs: which method of correcting the QT interval in dogs is appropriate for use in small animal clinics?

The electrocardiography (ECG) QT interval is influenced by fluctuations in heart rate (HR) what may lead to misinterpretation of its length. Considering that alterations in QT interval length reflect abnormalities of the ventricular repolarisation which predispose to occurrence of arrhythmias, this variable must be properly evaluated. The aim of this work is to determine which method of correcting the QT interval is the most appropriate for dogs regarding different ranges of normal HR (different breeds). Healthy adult dogs (n=130; German Shepherd, Boxer, Pit Bull Terrier, and Poodle) were submitted to ECG examination and QT intervals were determined in triplicates from the bipolar limb II lead and corrected for the effects of HR through the application of three published formulae involving quadratic, cubic or linear regression. The mean corrected QT values (QTc) obtained using the diverse formulae were significantly different (ρ<0.05), while those derived according to the equation QTcV = QT + 0.087(1- RR) were the most consistent (linear regression). QTcV values were strongly correlated (r=0.83) with the QT interval and showed a coefficient of variation of 8.37% and a 95% confidence interval of 0.22-0.23 s. Owing to its simplicity and reliability, the QTcV was considered the most appropriate to be used for the correction of QT interval in dogs.

Estimation of weed dry biomass and grain yield as a function of growth and yield traits under allelopathic weed management in maize

Growing concerns about toxicity and development of resistance against synthetic herbicides have demanded looking for alternative weed management approaches. Allelopathy has gained sufficient support and potential for sustainable weed management. Aqueous extracts of six plant species (sunflower, rice, mulberry, maize, brassica and sorghum) in different combinations alone or in mixture with 75% reduced dose of herbicides were evaluated for two consecutive years under field conditions. A weedy check and S-metolachlor with atrazine (pre emergence) and atrazine alone (post emergence) at recommended rates was included for comparison. Weed dynamics, maize growth indices and yield estimation were done by following standard procedures. All aqueous plant extract combinations suppressed weed growth and biomass. Moreover, the suppressive effect was more pronounced when aqueous plant extracts were supplemented with reduced doses of herbicides. Brassica-sunflower-sorghum combination suppressed weeds by 74-80, 78-70, 65-68% during both years of study that was similar with S-metolachlor along half dose of atrazine and full dose of atrazine alone. Crop growth rate and dry matter accumulation attained peak values of 32.68 and 1,502 g m-2 d-1 for brassica-sunflower-sorghum combination at 60 and 75 days after sowing. Curve fitting regression for growth and yield traits predicted strong positive correlation to grain yield and negative correlation to weed dry biomass under allelopathic weed management in maize crop.

Volunteer RR® corn management in roundup ready® soybean-corn succession system

The present study evaluated the effects of cover crops (Pennisetum glaucum, Crotalaria spectabilis and Urochloa ruziziensis) associated with the application of herbicides {glyphosate; (glyphosate + haloxyfop-R); (glyphosate + fluazifop-p-butyl); (glyphosate + imazethapyr) and (glyphosate + imazaquin)} in soybean desiccation management for volunteer RR® corn control. The experiment was conducted under field conditions at Sinop-MT, during the 2013/2014 crop season, in a randomized complete blocks design with factorial scheme and four replications. The following parameter were evaluated: dry matter of cover crops and ground coverage rate, control of volunteer RR® corn present at the time of desiccation, dry matter, height and intoxication level on soybean plants caused by herbicides at 7, 14 and 28 days after emergence (DAE), control of volunteer RR® corn derived from emergence fluxes subsequent to desiccation management and soybean yield. The joint application of (glyphosate + haloxyfop-R) provided the best level of volunteer RR® corn control present at the time of desiccation. Satisfactory control (80%) of volunteer corn was obtained with the application of (glyphosate + imazethapyr). This treatment displayed an additional residual effect of imazethapyr, which efficiently controled volunteer RR® corn derived from fluxes subsequent to desiccation management, especially in treatments performed under U. ruziziensis straw. None of the herbicides used in desiccation management caused any significant effect on dry matter, height and phytotoxicity of soybean plants at 7, 14 and 28 DAE nor on grain yield.

Glyphosate Herbicide Use in Urochloa brizantha Management in Intercropping With Herbicide-Resistant Maize

The success of the intercropping among cultivated species depends on the adoption of practices that provide, in due course, greater competitive ability of a species over another. The objective of this study was to evaluate the use of glyphosate herbicide in the suppression of Brachiaria (signalgrass) intercropped with maize. The experiment was conducted in a randomized complete block design with four replications. The treatments were arranged in a 5 x 2 + 2 factorial arrangement, the first factor corresponding to the doses of glyphosate (48, 96, 144, 240, 480 g ha-1 of the acid equivalent (a.e)) and the second one to the vegetative stages of the signalgrass at the time of application (2 and 4 tillers). Two controls were added to the treatment list, comprising controls without herbicide application and hand removal of the signalgrass. The number of plants, tillers and dry matter of signalgrass was reduced with glyphosate. The increase of the glyphosate doses enhanced the injure to the forage plants, mainly when the compound was sprayed at the two-tiller vegetative stage. The dry matter of maize plants increased proportionally to the glyphosate dose. However, the height of the maize plants was not affected. The grain mass and productivity of maize grain increased with increasing dose of glyphosate. The maize yield was negatively influenced on the untreated control. Glyphosate at 96 and 144 g ha-1, when applied at 2 and 4 tiller stage, respectively, reduces the growth of signalgrass and does not affect the maize grain yield.